Rheumatoid arthritis is the most common inflammatory arthritis. This is where the patient’s own immune system attacks the lining of the joint (the synovium). Patients with an inflammatory arthritis often notice their joints are stiff and ache in the morning but are better late in the day. Inflammatory arthritis can severely damage joints but it can be well controlled with modern anti-inflammatory medication. Arthritis eventually wears away the smooth cartilage covering the surface of the joint and the bone underneath becomes damaged. This causes joint pain and stiffness, which can interfere with normal activities.
Paracetamol – this is a very effective pain killer for arthritis and has very few side effects. It should be used under instruction from your GP but I usually recommend it be taken regularly, at full dose. Anti-inflammatories (Ibuprofen, Naproxen) act in a different way to Paracetamol. They reduce inflammation (redness, pain, swelling etc.) in the joint. It can have side effects and should only be taken after consultation with your GP. These can be stomach pain/bleeding, worsening of asthma and kidney failure.
Supplements to your diet, such as cod liver oil or Glucosamine, may also help relieve your symptoms. You should check with your doctor before you take supplements.
Using a walking stick can make walking easier. It should be held in opposite hand to the affected hip but on the same side as a painful knee.
Physiotherapy and regular moderate exercise can help to reduce stiffness and strengthen weak muscles. It also helps if a patient is due to have a joint replacement. Patients with strong supple joints find the post op physiotherapy easier and recover more quickly.
A steroid injection into your joint can sometimes reduce pain and stiffness for several months, particularly for inflammatory arthritis. Steroid injections are not usually given more than two or three times a year. Artificial Hyaluronic acid can also be injected and replaces some of the body’s natural joint fluid.
There are many different types of knee replacement available but I recommend the Corail / Pinnacle Total Hip Replacement and the PFC Total Knee Replacement. Both have excellent long-term results and give a superb functional outcome.
An incision in the middle of the knee or the side of the hip is performed and the arthritic surfaces are removed. These are then replaced with an artificial joint made of metal, plastic, ceramic, or a combination of these materials. The knee replacement is fixed to the bone using Methyl Methacrylate cement. The hip replacement has a special Hydroxyapatite coating that bonds directly to the skeleton.
At the end of the operation, the skin is closed with clips.
Typically patients will be up and out of bed on the first day after surgery. This is the best way to reduce the complications of blood clots, chest infections and pressure sores. Most patients will go home on approximately day three or four after surgery. The clips in the skin are removed approximately 10 to 14 days after surgery and the patient is then reviewed in clinic at six weeks.
Intelligence, D. F. (2011). Inside your hospital: Dr Foster Hospital Guide 2001-2011. London: Dr Foster Limited.